DR. SHANE J DOOT (NPI# 1124175963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124175963 |
| Entity Type | Individual |
| Full Name | DR. SHANE J DOOT |
| Credential | D.D.S. |
| Practice Address |
7400 W College Dr Palos Heights IL 60463-1155 |
| Practice Telephone | 7084488670 |
| Practice Fax Number | 7084488698 |
| Mailing Telephone | 7084488670 |
| Mailing Fax Number | 7084488698 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
IL | Dental Providers |
| Street Address |
7400 W COLLEGE DR |
| City | PALOS HEIGHTS |
| State | IL |
| Zip Code | 60463-1155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427105378 | Terrence M Wall | Dentist | 7400 W College Dr, Palos Heights, IL 60463-1155 | 2007-01-04 |
| 1063754984 | Lawrence J. Meekma | Dentist | 7400 W College Dr, Palos Heights, IL 60463-1155 | 2013-03-18 |
| 1134453988 | Nicholas R Cudney | Dentist | 7400 W College Dr, Palos Heights, IL 60463-1155 | 2009-09-28 |
| 1679761969 | Midwest Oral and Maxillofacial Surgery | Dentist | 7400 W College Dr, Palos Heights, IL 60463-1155 | 2007-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932756095 | Kim Rusiecki | Technician | 25 Parliament Drive East, Palos Heights, IL 60463 | 2019-08-23 |
| 1265925218 | Sentinel Anesthesia of Illinois, PC | Anesthesiology | 7340 W College Dr Fl 1, Palos Heights, IL 60463 | 2018-06-13 |
| 1225410848 | Deborah Ann Castaneda | Skilled Nursing Facility | 12350 Natchez Ave., Palos Heights, IL 60463 | 2015-06-19 |
| 1609253160 | Tareq Ayyad | Physical Therapy Assistant | 11730 Lighthouse Ln, Palos Heights, IL 60463 | 2015-05-04 |
| 1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
| 1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
| 1275976045 | Nazim A. Khan | Physician Assistant | 6450 West College Drive, Palos Heights, IL 60463 | 2013-04-11 |
| 1619246824 | Amanda M Ejka | Psychologist | 11800 South 75th Avenue, Suite 300, Palos Heights, IL 60463 | 2011-12-16 |
| 1578832937 | Sandi Maheras | Pharmacist | 1703 Spyglass Cir, Palos Heights, IL 60463 | 2011-12-14 |
| 1043597065 | Ashraf Olwan | Pharmacist | 7660 W Sequoia Rd, Palos Heights, IL 60463 | 2011-11-04 |
| Find all providers in zip 60463 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427105378 | Terrence M Wall | Dentist | 7400 W College Dr, Palos Heights, IL 60463-1155 | 2007-01-04 |
| 1679761969 | Midwest Oral and Maxillofacial Surgery | Dentist | 7400 W College Dr, Palos Heights, IL 60463-1155 | 2007-10-11 |
| 1568489144 | Kevin Francis Kennedy | Dentist | 7110 W 127th St, Palos Heights, IL 60463-1560 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1215410584 | David Peterson | Dentist | 1619 Brandywine Ln, Dixon, IL 61021-8757 | 2018-09-12 |
| 1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
| 1093232951 | Robert C. Bosack, Dds & Associates, Ltd | Dentist | 16011 108th Ave Ste A, Orland Park, IL 60467-8787 | 2017-08-23 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1770962375 | Eunsu Jung | Dentist | 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 | 2015-05-28 |
| 1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
| 1043607872 | Alissa Nicole Pullos | Dentist | 105 E 1st St Ste 103, Hinsdale, IL 60521 | 2015-04-20 |
| 1538592654 | Matthew Seena Hamedani | Dentist | 3116 Oak Park Ave, Berwyn, IL 60402 | 2013-08-13 |
| 1578907689 | M Timothy Murphy | Dentist | 500 Davis St Ste 509, Evanston, IL 60201-4621 | 2013-04-18 |
| Find all providers with the same taxonomy | ||||
| City | PALOS HEIGHTS |
| Zip Code | 60463 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.